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Mounds View Planning Application <br />Present Use of Property <br />Property Classification ? Abstract ? Torrens <br />Descriptian af Proposal (attach additiona supporting documentation if necessary) <br />Subdivide 7.14 acres into 15 sinqle family lots <br />Page 2 <br />Please Note: Applicants are responsible for all costs incurred ass�ciated with the filing, review and processing of this application. <br />Such fees are to be paid in escrow up front or upon recelpt of statement from the Ciry of Mounds View. Fees may include but are <br />nat limited to costs for consultants retained by the City, consultant planning services, attorney, and engineer fees. A deposit may <br />aiso be required to cover costs of public notices, materials and stafF time spent in the review, research or preparation of materials <br />associated with this application, The applicant shall be responsible for all reasonable incurred costs in excess of the initial deposit <br />amount. Any portion of the deposit not spent or encumbered shail be refunded to the applicant within 30 days after consideration <br />of the application is completed. Payment of park dedication fees is required with subdivision applications. <br />I ACKNOWLEDGE THAT I have read all of the inFormatinn listed in the Planning Application and fully understand that T am <br />responsible for all c.osts�ir uF d by the City related to the processing of this application. <br />?lt_ �'- � �'/I,E.S %�3/3 <br />Applicant Date <br />BY MY (OUR) SIGNATURE ON THIS APPLICATION, I HE�tEBY DECLARE THAT, TO THE <br />BEST OF MY KNOWLEDGE, THE INFORMATION PROVIDED IS TRUE AND ACCURATE. <br />Name of Applicant (typed/pri <br />Signature of Applicant <br />Eichi, Inc,, Martin N. Harstad, President <br />i�<`"S. <br />Name of Property Owner (ryped/printed) Keitlz T. Harstad <br />Signature of Properly Owner �� �l G��,�---`�"i __ <br />Address of Owner 2195 Silver Lake Rd. , New Brighton, MIV 55112 <br />Phone Number of Owner 651-636-9991 <br />E-mail � <br />**************************************************************************************** <br />FOR OFFICE USE ONLY <br />Date of Submittal _ <br />60-day Limit <br />Planning Case No(s) <br />Appiicat(on: <br />Park Dedication: <br />Deposits: <br />Qther: <br />Total: <br />Fees Paid: <br />Date of Acceptance; <br />120-day limft: <br />Assigned to: <br />Account # Check # Receipt # <br />i oioz <br />